Health clinics designed for busy people are popping up in unexpected places across the country, including department stores, grocery chains, and the skywalk system in downtown Des Moines.

In May, Mercy Medical Center – Des Moines opened its Quick Care Clinic at 604 Locust St., Suite 210, on the skywalk level of the Equitable Building. The opening of the clinic marked Mercy’s entry into a fast-growing segment of the health-care industry aimed at people who don’t have the time, or in some cases the money, to visit a traditional doctor’s office. These clinics, usually staffed by nurse practitioners, operate on a first-come-first-served basis and limit themselves to treating patients who have common illnesses such as strep throat or ear infections. They are not intended to replace primary-care providers or offer emergency care.

“Patients can be in and out in as quick as 10 or 15 minutes,” said Suzy Frein, manager of the Mercy Campus Medical Clinic and the Quick Care Clinic. “When people get diagnosed quicker, they can start to feel better sooner.”

According to Frein, Mercy had been looking into the idea of opening a limited-care clinic for some time. A phone call earlier this year from local developer Bob Knapp, who is overseeing the renovation of the Equitable Building, finally got the ball moving.

“We’ve been paying close attention to how this concept is taking off across the country,” Frein said. “Apparently up in Minnesota and across the Midwest, they’re doing what they call MinuteClinics. When a developer approached us about offering that concept in downtown Des Moines, we ran with it from there.”

According to a recent article in the Los Angeles Times, Minnesota-based MinuteClinic Inc., just one of growing number of companies marketing themselves as a place to get fast health care, plans to open 200 offices in about two dozen U.S. cities over the next four years. Retail giants Wal-Mart Stores Inc. and Target Corp. are also started to open quick-care centers. West Des Moines-based Hy-Vee Inc. has opened a handful of in-store clinics during the past six months, with plans to open several more.

“Clinics in retail stores have been extremely successful, and I don’t doubt that this one will be, too,” Frein said. “Our long-term goal is to have several of these clinics strategically placed around town in areas with a lot of public traffic. But we’re still working on plans for our next steps.”

The Quick Care Clinic is smaller than Mercy’s other clinics, with only two examination rooms. But like other Mercy clinics, it accepts most major insurance plans. A nurse practitioner at the clinic handles everything from taking patient information, examining the patient, collecting insurance co-pays and writing prescriptions. If the nurse practitioner determines that the patient needs treatment not offered by the clinic, the patient will not be charged for the visit and will be assisted in scheduling an appointment at another Mercy clinic.

The Mercy Quick Care Clinic is open from 7:30 a.m. to 5 p.m. Monday through Friday to anyone over 18 months of age, but Frein said most of its patients are either people who work downtown or are in town on business. Mercy representatives are meeting with companies based downtown to spread the word about the new clinic.

“Employers are showing a favorable response to the clinic,” Frein said. “Because we’re conveniently located, it decreases the amount of time staff is gone from the office for doctor’s appointments.”

According to Frein, the clinic currently treats five to seven patients per day, mostly first thing in the morning, over lunchtime or late in the afternoon. Frein expects traffic through the office to increase after summer and as more people become aware of its services.

“It’s convenient from an employee’s standpoint because they no longer have to take a half-day off from work to run across town to go the doctor when they have a common illness,” Frein said. “When it’s so easy to get treated, it decreases the amount of time they expose their co-workers to their germs.”

Opening medical clinics in high-traffic areas is not new. Two decades ago, clinics sprung up in shopping malls across the country, but later closed due to high overhead costs. According to Gregg Lagan, a spokesman for Mercy Medical Center – Des Moines, the health system launched its clinic network in Greater Des Moines in the mid-1980s with a branch at Valley West Mall. That office closed when Mercy West opened.

Over the past six months, Hy-Vee has opened in-store medical clinics at its grocery stores in Davenport, Columbus, Neb., and two in Omaha. Another four clinics are slated to open soon in Sioux City. Hy-Vee spokeswoman Chris Friesleben said the company is pleased with the early feedback about the clinics that are open.

“Our whole concept is offering convenience to our customers, and we’d like to offer as many things to our populace as we can,” Friesleben said.

The Hy-Vee quick-care clinics are operated by other companies. In the case of the Davenport store, the clinic is operated by Trinity Regional Health Systems. Alegent Health, a statewide health group, runs the Omaha clinics. The Columbus clinic and the ones planned for Sioux City are managed by Curaquick Clinics, a new Sioux City-based company focused on providing health care in retail settings.

“It’s a common-sense approach to health care,” Friesleben said. “When you’re running around all day with work and kids’ activities, the last thing you want to do is sit in a doctor’s office and wait. Most likely, you probably have to go to the grocery store anyway, so you can drop into the clinic and get taken care of.”

In addition to people who are too busy to go to the doctor for common illnesses, Curaquick clinics are designed to be an affordable option for people who don’t have health insurance. The clinics charge a flat rate of $35 to $40 per visit and do not accept insurance co-pays.

“Unfortunately, the number of uninsured is on the rise nationally, and many people are going without care because they cannot afford to go to the doctor,” Friesleben said. “As long as they have a minor illness, we can offer care to them at a reasonable cost.”

Clinic hours vary, but they are generally aligned with those of Hy-Vee’s in-store pharmacies, Friesleben said. But clinic patients are not required to fill their prescriptions at Hy-Vee.

Dr. Tim Gutshall, a clinical coordinator for the Iowa Foundation for Medical Care and an emergency room physician, sees both positives and negatives to the growth of limited-care clinics such as Mercy’s Quick Care Clinic and the ones inside stores.

“These clinics meet a need in providing access to care,” Gutshall said. “When I ask my patients in the emergency room why they didn’t go to their primary doctor for their problem, many of them tell me that they were told they would have to wait three days to get an appointment. People can go to these walk-in clinics and be seen right away.”

But one drawback Gutshall sees to the quick-care clinics is that people get in the habit of getting medical care from several different sources, and that medical information is not shared between offices.

“The big issue is having a medical home,” Gutshall said. “I believe that everybody should have a primary-care doctor who knows the patient well and has access to all the tests, records and everything that has ever been done to the patient. When the patient is being seen by someone else all of a sudden, that information probably doesn’t get back to the primary-care doctor. That information is important to have a comprehensive look at the patient.”

Although clinics in retail settings are becoming more common, not everyone likes the concept. One objection is that people who are out shopping for food, clothing or household supplies shouldn’t have to worry about being exposed to a slew of sick people. Friesleben dismisses that concern.

“These are not people who would stay home with whatever ailment they have,” she said. “They’re already out and about intermingling with people, working, shopping, picking up their children and so forth. People have been sharing the aisles with sick people before.”

Friesleben said Greater Des Moines is among the cities Hy-Vee will consider as it maps out its plan to open more clinics.

“I’ve already had calls from stores that want to have one of these clinics and a call from a customer a few weeks ago who wanted to know why we haven’t opened one here yet,” Friesleben said. “I think people are getting more used to seeing these where they shop and they’re going to demand more of them.”